Globe and Mail March 2, 2006

Premier says medicare plans 'may violate the Canada Health Act'
By Katherine Harding and Gloria Galloway

Edmonton and Ottawa — Alberta's sweeping health-care proposals aren't "written in stone," Premier Ralph Klein said yesterday, but warned he would not shy away from a fight with Ottawa to get what he wants.

Mr. Klein said he doesn't know yet how much of his 10-point plan will remain intact after a public consultation period, scheduled to last a month. If the subsequent legislation breaches federal health rules, however, he's ready to do battle with the new Conservative government.

"It may violate the Canada Health Act," he told reporters.

Mr. Klein's comments came hours after Prime Minister Stephen Harper warned the province that any changes to its health-care system must conform to the Canada Health Act and suggested that he greatly prefers Quebec's solution for reducing waiting times for treatment.

Mr. Harper did not directly condemn any part of his home province's new health policy, which includes a proposal to allow doctors to work in both the public and private systems and to permit patients to pay to have some non-emergency procedures done quickly.

But he served notice that his government will be carefully examining the Alberta plan, which, at this point, is little more than a discussion paper, and will have a full response in the days to come.

"As we do our own review of the proposals that Alberta has put out, we are going to want to satisfy ourselves that they are within the Canada Health Act," Mr. Harper told reporters during a news conference in the lobby of the House of Commons.

"And I would think the government of Alberta would want to do the same thing, given that I know the Premier and the government of Alberta have long committed -- and repeatedly committed in legislation and elsewhere -- that they will respect the Canada Health Act."

Mr. Harper continued: "And that's a commitment they've made not just to the government of Canada, that's a commitment they've made to Alberta citizens."

Mr. Klein said, however, that he wouldn't rule out changing a provincial law that currently enshrines the Canada Health Act in Alberta's own legislation.

Despite his tough talk, Mr. Klein said he was "frustrated" that critics of his proposals were focusing only on the aspects that deal with the private delivery of health care. He told reporters that if Alberta goes ahead with legislation that breaches federal health rules, he would prefer to sort out any resulting problems with Ottawa using a special dispute-resolution process.

Mr. Klein did strike a conciliatory note, however, saying it is conceivable that the most controversial aspects of his 10-point plan could eventually be scrapped and that he's open to ideas from not just Albertans, but the rest of the country.

One of the five key principles of the Canada Health Act is accessibility; all insured residents of a province must have access to the same level of health care.

Critics of the Alberta plan argue that principle would be violated if rich patients were permitted to pay for faster service in the private system. And, while Alberta Health Minister Iris Evans has said all doctors will be required to perform work in the public system, opponents of private care fear that allowing them to also work for profit will drain public health-care resources.

Mr. Harper suggested yesterday that Quebec, which issued its own proposal for health-care reform less than two weeks ago, had developed a better solution for reducing the lengthy waiting times that are jeopardizing public health care. The Quebec plan also involves the use of private treatment, but on a more limited basis than the one put forward by Alberta.

"Quebec has put out significant major changes, reforms to the health-care system but reforms that clearly respect principles of the Canada Health Act. I would encourage all provinces to do that," he said.